大肠粘膜腺管开口对粘膜病变的诊断价值

目的：探讨放大内镜结合腺管开口分型在诊断大肠粘膜病变性质的临床应用价值。方法：放大内镜检查中，发现病变后，对病灶喷洒靓胭脂，采用放大内镜观察病灶粘膜腺管开口形态，按Kudo分型作病灶性质判断 ，并与切除或活检组织作病理学比较。结果：在194处病灶中，放大内镜诊断为炎性息肉、管状腺瘤、绒毛状腺瘤和大肠癌的病理符合率分别为100.0％、93.3％、90.9％、100.0％，总病理符合率为96.1％。结论：放大内镜对判断大肠病变性质有较高的病理符合率，使我们能够区分肿瘤与非肿瘤，良性与恶性肿瘤，预测癌的浸润深度，决定合适的治疗方式，具有较高的临床应用价值。

The clinical value of magnifying endoscopy in detection and diagnosis of colorectal lesion

Objective To evalulate the clinical value of magnifying endoscopy in combination with pit pattern in detection and diagnosis of colorectal lesions. Methods Once the lesions were detected by magnifying endoscopy, sprayed with Indigo Carmine, observed the shape of the pit pattern based on Kudo standard of classification, and compared with histologic diagnosis. Result The accuracy of magnifying endoscopy compared with histological diagnosis of inflammatory polyps, tubular adenomas, villaus adenomas and colorectal cancer was 100%,93.3%,90.9% and 100%respectively. The overall accuracy was 96.1 %. Conclusions Magnifying endoscopy has high efficacy in judging the nature of lesions, and has enabled us to distinguish between neoplasic or non-neoplastic, decide benign or malignant, forecast the depth of cancer in vasion and decide a suitable endoscopic treatment. It is valuable in dectected and diagnosis of colorectal lesions.